Provider Demographics
NPI:1083612410
Name:DELAMERCED, AMADOR S JR (MD)
Entity Type:Individual
Prefix:
First Name:AMADOR
Middle Name:S
Last Name:DELAMERCED
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 HARRISON AVE STE 2500
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1726
Mailing Address - Country:US
Mailing Address - Phone:513-347-2300
Mailing Address - Fax:513-451-2135
Practice Address - Street 1:5885 HARRISON AVE STE 2500
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-1726
Practice Address - Country:US
Practice Address - Phone:513-347-2300
Practice Address - Fax:513-451-2135
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0929660Medicaid
OH0929660Medicaid